Filing a Restitution Affidavit in Stearns County: Step-by-Step for Crime Victims
If you've had out-of-pocket costs because of a crime, Stearns County's restitution affidavit is how you document those losses. The goal: give the court a clear, supported dollar amount tied directly to the offense.
The restitution affidavit puts your out-of-pocket losses on record. You'll use it to capture costs like medical or therapy bills, lost wages, property damage or loss, insurance deductibles, and other expenses directly tied to what happened.
Had expenses from the offense? Check the box indicating you wish to request restitution. This tells the court you want to be repaid through the case.
Not claiming losses? The form includes a clear "no" option. You can indicate you're not claiming any monetary loss or don't wish to receive restitution - this prevents confusion later about whether you're asking the court for money.
Types of Expenses
- ✓ Medical and therapy costs you paid out of pocket
- ✓ Replacement of wages and services you lost because of the crime
- ✓ Property loss or property damage tied to the offense
- ✓ Insurance deductibles you had to pay because of the loss
- ✓ Other expenses that are directly related to the crime
How to Document
- ✓ Copies of actual medical bills
- ✓ Copies of repair receipts
- ✓ Copies of replacement receipts
- ✓ Copies of estimates for repairs
Requesting restitution? You'll fill out the Financial Impact Worksheet. This is where you list each expense caused by the crime - no lump-sum guesses without a breakdown.
- List each expense separately - use a new line for each cost that resulted from the crime so it’s easy to follow.
- Match every number to paperwork - attach copies of bills, receipts, repair/replacement paperwork, and estimates that support the amounts you’re claiming.
- Add a clear subtotal - total the worksheet so the final number reflects what you’re requesting.
Beyond the dollar amounts, you may see a few extra questions - things that clarify your situation or what other assistance you've applied for. Read each prompt carefully. If a section doesn't apply, skip it; the worksheet expects that not every part fits every case.
Required signature: Sign under penalty of perjury, confirming the information is true and correct. If the victim is under 18, a parent or guardian signs. An agent or representative may sign when appropriate.
Practical Next Steps
- ✓ Gather documents that prove your losses (medical bills, repair/replacement receipts, and repair estimates)
- ✓ Fill out the Financial Impact Worksheet with each expense that resulted from the crime
- ✓ Make sure the expenses you list fit the affidavit’s out-of-pocket loss categories (medical/therapy, lost wages/services, property loss/damage, insurance deductibles, and other directly related expenses)
- ✓ Attach copies of your supporting paperwork to back up every line item
- ✓ Sign the affidavit under penalty of perjury (victim, or agent/representative, or parent/guardian if the victim is under 18)
- ✓ Submit the affidavit and attachments using the instructions provided with your Stearns County paperwork
Find an Inmate at Stearns County Jail, MN
Search for a loved one and send messages and photos in minutes.
